PubMedID: 24482901

OBJECTIVESTo evaluate the effectiveness and safety of endoscopic balloon dilatation in children with esophageal stenosis.

PATIENTS AND METHODSRetrospective study of patients treated in the last 5 years, diagnosed with esophageal stricture. Response to dilatation was defined as excellent when there was no need for any additional dilatation for recurrent dysphagia, satisfactory when they set out to 5 sessions, acceptable with more than 5 sessions, and inadequate if there was no improvement of dysphagia with dilation. The treatment was effective when dysphagia remained grade 0 or 1 was kept for more than 12 months after the last dilatation session.

RESULTS576 procedures were performed in 89 children, with an average of 6,47 per patient (range 1-33). The esophageal stenosis was secondary to esophageal atresia repair in 51 cases (57,3%), injury by caustic in 19 patients (21,3%) and gastroesophageal reflux 11 cases (12,3%); compromised aged between 1-202 months (mean 36,1). Response to dilatation was excellent in 11 patients (13.9%), satisfactory in 27 (34.1%), fair in 25 (31.6%), and inadequate in 16(20.2%). Ten patients (8.9%) were lost to follow up. Thirty-four (38.2%) patients were diagnosed with concomitant gastroesophageal reflux disease, every one recieved medical management and 7 (20,5%) underwent antireflux surgery. The treatment was effective in 63 cases (79.7%) and ineffective in 16 (20.2%), most of the latter with gastroesophageal reflux. There were 8 complications (1,38%), all esophageal perforations.

CONCLUSIONSEndoscopic balloon dilatation can be accomplished safely and effectively as a first-line therapy for the management of esophageal stenosis.